Organization
PINEO FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSS VICTOR PINEO DDS (OWNER)
(814) 734-4451
Entity
Organization
Contact information
Practice address
606 ERIE ST, EDINBORO, PA 16412-6002
(814) 734-4451
(814) 734-2863
Mailing address
606 ERIE ST, EDINBORO, PA 16412-6002
(814) 734-4451
(814) 734-2863
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS035169
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011637470001
—
PA
01
—
1384880
BCBS
—
Enumeration date
08/05/2006
Last updated
08/22/2020
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